Treatment of glioma is currently one of the most challenging problems in oncology, as well as in neurosurgery. Despite major advances in our understanding of the pathomechanism, diagnosis by imaging and the availability of powerful therapeutic tools, the life expectancy of patients with glioblastoma has only been slightly prolonged and a cure remains elusive. None of the currently available surgical tools, including operative microscopes, lasers and image-guided surgery, can enable the detection and removal of all of the tumor tissue. In recent years, however, the landscape has been changing immeasurably, and molecular studies over the past two decades have identified a variety of genetic aberrations that are specifically associated with individual types of gliomas. In addition, certain molecular abnormalities have been linked to therapy responses, thereby establishing clinical biomarkers and molecular targets, and the use of novel agents is being investigated. These agents have been specifically engineered to exert specific cytotoxicity against gliomas, either on their own as single agents or in combination with other modalities. Moreover, there has been an enormous surge of interest in the area of immunology and immunotherapy, which has been facilitated by our understanding of the molecular basis of gliomas. Although several kinds of immunotherapeutic trials have been undertaken, we still await a great breakthrough in terms of clinical efficacy to prolong the survival time of glioma patients.